Mental illness in China/Authors' reply

For depression, some of these symptoms such as "pessimism" are more like optional or unrecognised than core diagnostic symptoms of DSM-IV depression.2 Secondary probes for various anxiety disorders were not mentioned. Since diagnoses based on these innovatively broadened SCID questions have never been validated, the conceptual and empirical justification for making the modifications to generate higher prevalence is debatable. The first interpretation is contrary to the documented episodic nature of common mental disorders,3 and the second is obviously implausible. Since probing lifetime episodes of every disorder with the SCID is tedious, the 45-min interviews might not have been thorough enough.